What You Need to Know About the Coronavirus

What can older adults do to reduce their risk of illness?
The Centers for Disease Control and Prevention (CDC) has issued new guidance for older adults and people who have chronic medical conditions, such as heart disease, diabetes and lung disease. This population is at increased risk for serious illness from COVID-19, the disease caused by the new coronavirus. Here’s what the agency recommends:

Older Americans and adults who take routine medications should make sure they have “adequate supplies” on hand as the number of confirmed COVID-19 cases continues to climb in the U.S., said Nancy Messonnier, an internist and director of the CDC’s National Center for Immunization and Respiratory Diseases. It’s also important to keep over-the-counter medications to treat fever and other symptoms at home, as well as tissues and other common medical supplies.

If you run into difficulty stocking up on your prescriptions at the pharmacy, consider refilling your medications with a mail-order service, the CDC says. And make sure you have enough food on hand, should you have to stay home for an extended period of time.

The new guidance comes as a long-term care facility in Washington battles an outbreak of the respiratory illness caused by the coronavirus, coupled with new research out of China that shows older adults and people with underlying health conditions — such as heart disease, lung disease and diabetes — were “about twice as likely to develop serious outcomes” from COVID-19, compared to “younger, healthier people,” Messonnier said in a news briefing last week.

“We are particularly concerned about these people, given the growing number of cases in the United States, as well as those with suspected community spread,” Messonnier added. “What is happening now in the United States may be the beginning of what is happening abroad.”

Avoiding sick people and washing your hands often are two preventive strategies public health experts have been pushing to help slow the spread of COVID-19. Older Americans living in areas that are experiencing spikes in coronavirus cases may also need to “think about what actions” they can take to reduce exposure to the virus, Messonnier said.

This may include social distancing strategies, such as teleworking and avoiding large public gatherings, especially in poorly ventilated spaces.

“Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick,” the CDC says.

If COVID-19 begins spreading in your community, keep in touch family and friends by phone or email to let them know how you are doing. And if you rely on a caregiver for routine help, make arrangements for backup care in case your primary caregiver becomes sick.

Finally, the government is encouraging older adults and people with underlying health conditions to re-think travel plans that put them at risk of contracting COVID-19, such as cruise ship travel and long plane rides.

What is the U.S. doing to prepare for a potential outbreak?

Health officials have warned that though risk of infection from the coronavirus that emerged from Wuhan, China, in December is still low for the general American public, individuals and communities should be prepared for an outbreak.

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness,” Messonnier said.

In the absence of a vaccine to prevent COVID-19 or medication to treat it, health officials and government leaders are preparing for an outbreak with non-pharmacological interventions. What these interventions look like at the community level will vary, depending on local conditions.

“Social distancing” — avoiding crowds and staying home when you are sick — will likely be one of the top strategies recommended by officials. Depending on the severity of the situation, communities may see school closures, an increase in teleworking and the cancellation of mass gatherings. In areas where the illness is spreading, this is already happening.

In the health care setting, hospitals may need to triage patients differently, and providers may need to increase telehealth services and delay elective surgeries. Workers should be asking their employers if teleworking is an option. And people with children and grandchildren can check in with school systems about plans for teleschooling.

“All of these questions can help you be better prepared for what might happen,” Messonnier said.

Though these types of disruptions to everyday life seem “overwhelming and severe,” Messonnier emphasized these “are things people need to start thinking about now.”

The decision of what steps to implement when will be up to local officials. On Thursday, Congress agreed on an $8.3 billion bipartisan package to help provide funding to state and local health agencies.

“During an outbreak of a new virus, there is a lot of uncertainty,” Messonnier acknowledged. Guidance and advice will likely be “interim and fluid, subject to change as we learn more,” she added.

What’s the best way to protect myself?

The best way to prevent the spread of COVID-19 is to limit exposure. This means avoiding destinations that have reported spread of the virus, and thinking twice “before you expose yourself to someone who is showing symptoms,” the CDC’s Messonnier said.

Health officials also advise taking everyday steps that can prevent the spread of respiratory viruses. Wash your hands often with soap and water (scrub for at least 20 seconds), and use alcohol-based hand sanitizer when soap is not an option. Avoid touching your eyes, nose and mouth with unwashed hands, and cover your coughs and sneezes.

Some other advice: Stay home when you are sick, and clean and disinfect frequently touched objects and surfaces. “This is the other side of not spreading the disease, which is not catching it,” Messonnier said.

Is there anything I can do to prepare for an outbreak?

It’s never a bad idea to get your household ready for an emergency situation, including the spread of COVID-19. In addition to making sure you have “adequate supplies” of routine medications on hand, the CDC has a checklist for how best to prepare for a community outbreak.

Some of the steps include planning for ways to care for those who may be at greater risk for severe complications from the illness and identifying aid organizations in your community. You can also create an emergency contact list, if you don’t have one already. Talk with your employer and schools about plans for potential closures, and identify a room in your home that can be used to separate sick family members from healthy ones to minimize the risk of the illness spreading.

“Right now, especially, individual actions can have an important impact on how this situation plays out,” Messonnier said.

What about travel plans?
The World Health Organization (WHO) and the U.S. government have declared the coronavirus outbreak a public health emergency, and federal officials are warning Americans not to travel to China, Iran, South Korea and Italy due to a high number of COVID-19 cases. Travelers headed to Japan also should exercise increased caution.

Older adults and people with chronic medical conditions should consider postponing nonessential travel – especially on cruise ships, since COVID-19 “appears to spread more easily between people in close quarters aboard ships,” the CDC says.

Cruise travelers should be prepared for strict screening procedures, the State Department says — even disruptions to travel itineraries and ability to disembark. Passengers planning cruise vacations should contact their cruise line companies directly on the current rules and restrictions.

If you do travel to a country that’s experiencing a spike in coronavirus cases, the CDC recommends that you wash your hands often, avoid contact with sick people, and avoid touching your eyes, nose and mouth with unwashed hands.

Because the risk of COVID-19 spreading throughout the U.S. community is still relatively low at this time, there is no reason to fear or halt domestic travel plans, said public health expert Syra Madad, who serves as the senior director of the System-wide Special Pathogens Program at New York City Health + Hospitals.

So far, the CDC has not issued travel warnings for domestic destinations. That said, if you are part of the population that is at high risk of serious illness from COVID-19 (older adults and people with underlying health conditions), you may want to re-think nonessential travel and avoid crowded places.

Because the situation is constantly changing, make sure you get your travel advice from credible sources, such as the CDC and WHO, Madad said. There’s a lot of misinformation out there fueling unwarranted fear and anxiety.

“It’s important to stay informed, but it’s not a time to panic right now,” she added.


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How is the coronavirus spreading?

Health officials are still trying to better understand how COVID-19 is spreading among people.

Most of what experts do know is largely based on what is known about similar coronaviruses. When person-to-person transmission occurred with Middle Eastern respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV), respiratory droplets from coughs and sneezes from an infected person were the likely culprit, according to the CDC. Those droplets can land in the mouths or noses of nearby people or be inhaled into the lungs.

It may be possible to get COVID-19 by touching a contaminated surface or object and then touching your mouth, nose or eyes, “but this is not thought to be the main way the virus spreads,” the CDC says.

Health officials are still working to better understand how easily the virus is spread from person to person. It may be possible for an infected person to spread the virus before exhibiting symptoms. However, people are thought to be most contagious when they are sick with the symptoms of the virus, the CDC says.

What are the symptoms?
Patients with COVID-19 have reported symptoms similar to other respiratory illnesses, including mild to severe symptoms of fever, cough and shortness of breath that typically begin two to 14 days after exposure, the CDC reports. Many patients with severe complications from the virus have pneumonia in both lungs.

The CDC is asking those with symptoms to call their health care provider or local health department for advice before seeking care to avoid spreading germs to others.

However, if you develop emergency warning signs – pain or pressure in the chest, disorientation or confusion, a blue tint in your face or lips, or difficulty breathing or shortness of breath – get medical attention immediately, health officials warn.

If your doctor suspects COVID-19 and orders a test, Medicare will cover the cost.

The CDC also has tips for what to do if you become infected with COVID-19.

How is it treated?

There is no specific antiviral treatment for COVID-19 at this time, just relief from symptoms. However, a clinical trial is underway to test the safety and efficacy of the drug remdesivir as a potential treatment in adults with COVID-19.

What’s the deal with a vaccine?

Scientists at the National Institutes of Health (NIH) and elsewhere have been working on developing a vaccine for COVID-19 since Chinese health authorities made the genetic sequence of the virus available. But a vaccine is likely a year away, at minimum, from being available to the public.

Why does it take so long?

A vaccine will need to be tested in monthslong clinical trials to determine its safety and effectiveness in people, explained Anthony Fauci, an immunologist and director of the National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH. If the vaccine proves safe and effective in the trials and is rushed through regulatory processes, it will still need to be produced for the masses, which will likely add several more months to the timeline.

Will a flu shot provide protection?

There is no evidence that the flu shot or the pneumococcal vaccination will provide any protection from the coronavirus, Messonnier said. Both, however, will increase your chances of staying healthy this winter. And it’s important to keep in mind that like COVID-19, the flu can be deadly. The CDC estimates that the flu was responsible for 34,200 deaths in the 2018-19 season.

Protecting yourself from the flu also lessens the burden on the health care system, should the U.S. see a spike in COVID-19 cases, New York City’s Madad said.

A healthy population helps hospitals “prioritize and focus on the patients that are coming in with this type of disease, versus those that are coming with seasonal flu,” she added.

What about those face masks?

Surgical masks offer some level of protection but only when worn properly. Experts recommend a snug-fitting N95 respirator, which blocks large-particle droplets and most small particles that are transmitted by coughs and sneezes, according to the Food and Drug Administration (FDA). These masks are usually available at most drugstores and home-improvement outlets.

That said, there is no need for them among the general public in the U.S. at this time, Messonnier said. And depleting supplies now will only make preventive efforts more complicated if the virus starts spreading in communities.

What about pets?

Global health officials say there’s no evidence, to date, that pets can get sick from the coronavirus that’s circulating the globe and infecting humans. And while the virus that causes COVID-19 “seems to have emerged from an animal source,” there’s also no indication that pets can pass it to people.

But it is always a good idea to wash your hands with soap and water after coming into contact with pets. “This protects you against various common bacteria such as E. coli and salmonella that can pass between pets and humans,” the WHO says.

What, exactly, is the coronavirus?

Coronaviruses, named for their crownlike shape, are a large family of viruses that are common in many species of animals. Several coronaviruses can infect people, according to the CDC. These strains mostly cause cold-like symptoms but can sometimes progress to more complicated lower respiratory tract illnesses, such as pneumonia or bronchitis.

On rare occasion, animal coronaviruses can evolve and spread among humans, as seen with MERS and SARS. The virus at the center of the latest outbreak is being referred to as a novel (new) coronavirus, since it’s something that health officials have not seen before.

To date, COVID-19, the illness caused by the new coronavirus, has sickened more than 93,000 people and killed nearly 3,000 (mostly in China). And the numbers continue to climb.

This story will be updated periodically with new developments in the global outbreak. Check back regularly.

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